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HIGGINSVILLE HABILITATION CENTER
NPI 1407803851
Family Medicine in Higginsville, MO

Active since May 30, 2006CLIA 26D0881545 · Waiver
100 WEST 1ST ST, HIGGINSVILLE, MO 64037(660) 584-2142(660) 584-6244 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 27, 2020, Aug 28, 2019 (2 updates tracked since 2019).

About Higginsville Habilitation Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HIGGINSVILLE HABILITATION CENTER (NPI 1407803851) is a healthcare organization registered as a family medicine in Higginsville, Missouri and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through January 11, 2028 and lists Molly Jane Boeckmann, Director Of Administrative Services, as its authorized official.

NPPES Registry Identity

NPI1407803851
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSTATE OF MISSOURI
Location Address100 WEST 1ST STHigginsville, MO 64037
Mailing Address1706 E Elm StJefferson City, MO 65101-4130 · (573) 751-3398 · Fax (573) 526-4560
Phone(660) 584-2142
Fax(660) 584-6244
Organization SubpartYes
Authorized OfficialMolly Jane BoeckmannDirector Of Administrative Services · (573) 751-4055
Enumeration DateMay 30, 2006
Last NPPES UpdateOctober 27, 20202 updates tracked since enumeration
NPPES CertifiedOctober 27, 2020
✔ NPI 1407803851 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
100 WEST 1ST ST, Higginsville, MO 64037
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Other Names 1

Doing Business AsHigginsville Habilitation Center

Other Identifiers 1

Medicaid501499701MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0881545

Higginsville Habilitation Center · Higginsville, MO
Active · expires Jan 11, 2028
CLIA Number26D0881545
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorJeramiah Gandhi
Laboratory Phone(660) 584-2142
Laboratory LocationHigginsville Habilitation CenterWest First Street P O Box 517, Higginsville, MO 64037
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is State Of Missouri's NPI number?

The NPI number for State Of Missouri is 1407803851. It was assigned to this organization in the NPPES registry on May 30, 2006.

Where is State Of Missouri located?

State Of Missouri is located at 100 West 1st St, Higginsville, MO 64037. The listed phone number is (660) 584-2142.

What is State Of Missouri's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does State Of Missouri hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0881545) is associated with this NPI, valid through January 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for State Of Missouri was last updated on October 27, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.